Cognitive Control Functions in Unipolar Major Depression with and without Co-Morbid Anxiety Disorder

Background: Impaired cognitive control functions have been demonstrated in both major depression (MDD) and anxiety disorder (A), but few studies have systematically examined the impact of MDD with co-morbid A (MDDA), which is the main aim of this study. Method: We compared patients with MDD with (MDDA; n = 24) and without co-morbid A (n = 37) to a group of healthy controls (HC; n = 92) on three subtests from the Cambridge Neuropsychological Test Automated Battery; intra–extra dimensional, stop signal task, and spatial working memory. These tasks correspond to a theoretical model consisting of three separable but interrelated executive control functions: Shifting, Inhibition, and Updating. A simple psychomotor speed measure was also included. Results: After controlling for age, gender, and education level, the results showed that the MDDA group displayed significantly impaired performance on the functions Shifting and Updating compared to HC. There emerged no significant differences between any of the patient groups and HC regarding Inhibition. The pure MDD group did not display dysfunctions relative to the HC group on the main executive control variables, but displayed slowed psychomotor speed. Contrary to expectation there were no significant differences between the MDDA and the MDD groups. Conclusion: Co-morbid anxiety should be taken into account when studying cognitive control functions in major depression.

[1]  E. Walker,et al.  Diagnostic and Statistical Manual of Mental Disorders , 2013 .

[2]  B. Baune,et al.  Impact of psychiatric and medical comorbidity on cognitive function in depression , 2009, Psychiatry and clinical neurosciences.

[3]  J. Suvisaari,et al.  The effect of psychiatric co-morbidity on cognitive functioning in a population-based sample of depressed young adults , 2009, Psychological Medicine.

[4]  E. Gudayol-Ferré,et al.  Comorbidity of anxiety disorders in major depressive disorder: A clinical trial to evaluate neuropsychological deficit , 2009 .

[5]  H. McNeely,et al.  Neurophysiological evidence of cognitive inhibition anomalies in persons with major depressive disorder , 2008, Clinical Neurophysiology.

[6]  P. Sachdev,et al.  Memory and executive functioning in obsessive-compulsive disorder: a selective review. , 2007, Journal of affective disorders.

[7]  P. Bräunig,et al.  Stability and course of neuropsychological deficits in manic and depressed bipolar patients compared to patients with Major Depression. , 2007, Journal of affective disorders.

[8]  S. Koole,et al.  Clearing the mind: a working memory model of distraction from negative mood. , 2007, Emotion.

[9]  Chao-Cheng Chen,et al.  Neurophysiological mechanisms in the emotional modulation of attention: The interplay between threat sensitivity and attentional control , 2007, Biological Psychology.

[10]  Dennis R. Combs,et al.  Comorbid anxiety corresponds with neuropsychological dysfunction in unipolar depression , 2007, Cognitive neuropsychiatry.

[11]  G. A. Miller,et al.  Cognitive Deficits in Depression and Functional Specificity of Regional Brain Activity , 2007, Cognitive Therapy and Research.

[12]  R. Porter,et al.  Neuropsychological Impairment in Major Depression: Its Nature, Origin and Clinical Significance , 2007, The Australian and New Zealand journal of psychiatry.

[13]  N. Fox,et al.  Behavioral and Electrophysiological Markers of Selective Attention in Children of Parents with a History of Depression , 2006, Biological Psychiatry.

[14]  E. Vieta,et al.  Clinical correlates of first-episode polarity in bipolar disorder. , 2006, Comprehensive psychiatry.

[15]  B. Klimes-Dougan,et al.  Neuropsychological Functioning in Adolescent Children of Mothers with a History of Bipolar or Major Depressive Disorders , 2006, Biological Psychiatry.

[16]  B. Sahakian,et al.  Differential performance on tasks of affective processing and decision-making in patients with Panic Disorder and Panic Disorder with comorbid Major Depressive Disorder. , 2006, Journal of affective disorders.

[17]  G. McCarthy,et al.  Brain Systems Mediating Cognitive Interference by Emotional Distraction , 2006, The Journal of Neuroscience.

[18]  Jeffrey S. Maxwell,et al.  Anxiety selectively disrupts visuospatial working memory. , 2006, Emotion.

[19]  A. Asbjørnsen,et al.  Cortisol level predicts executive and memory function in depression, symptom level predicts psychomotor speed , 2005, Acta psychiatrica Scandinavica.

[20]  J. Gross,et al.  The cognitive control of emotion , 2005, Trends in Cognitive Sciences.

[21]  A. Mykletun,et al.  Frequency and characteristics of recurrent major depressed patients with unimpaired executive functions , 2005, The world journal of biological psychiatry : the official journal of the World Federation of Societies of Biological Psychiatry.

[22]  O. Cameron,et al.  Anxious and depressive disorders and their comorbidity: Effect on central nervous system noradrenergic function , 2004, Biological Psychiatry.

[23]  John Duncan,et al.  State Anxiety Modulation of the Amygdala Response to Unattended Threat-Related Stimuli , 2004, The Journal of Neuroscience.

[24]  Alexander Neumeister,et al.  Evidence for continuing neuropsychological impairments in depression. , 2004, Journal of affective disorders.

[25]  Masato Fukuda,et al.  Executive and prefrontal dysfunction in unipolar depression: a review of neuropsychological and imaging evidence , 2004, Neuroscience Research.

[26]  Patrick Rabbitt,et al.  Do “Frontal Tests” Measure Executive Function? Issues of Assessment and Evidence from Fluency Tests , 2004 .

[27]  P. Rabbitt.  Introduction: Methodologies and models in the study of executive function , 2004 .

[28]  J. Duncan,et al.  Prefrontal cortical function and anxiety: controlling attention to threat-related stimuli , 2004, Nature Neuroscience.

[29]  K. Oedegaard,et al.  Impairment across executive functions in recurrent major depression , 2004, Nordic journal of psychiatry.

[30]  J. Leathem,et al.  Questioning the Link Between PTSD and Cognitive Dysfunction , 2003, Neuropsychology Review.

[31]  D. Fergusson,et al.  Major depression and cigarette smoking: results of a 21-year longitudinal study , 2003, Psychological Medicine.

[32]  J. Jolles,et al.  Cognitive functioning in young and middle-aged unmedicated out-patients with major depression: testing the effort and cognitive speed hypotheses , 2003, Psychological Medicine.

[33]  F. Vollenweider,et al.  Decision-making strategies by panic disorder subjects are more sensitive to errors. , 2003, Journal of affective disorders.

[34]  Christopher M. Janelle,et al.  Anxiety and Performance: A Visual Search Examination of the Processing Efficiency Theory , 2003 .

[35]  P. Holmans,et al.  Genetics of recurrent early‐onset depression (GenRED): Design and preliminary clinical characteristics of a repository sample for genetic linkage studies , 2003, American journal of medical genetics. Part B, Neuropsychiatric genetics : the official publication of the International Society of Psychiatric Genetics.

[36]  S. Lautenbacher,et al.  Divided and selective attention in panic disorder , 2002, European Archives of Psychiatry and Clinical Neuroscience.

[37]  C. MacLeod,et al.  Selective attention and emotional vulnerability: assessing the causal basis of their association through the experimental manipulation of attentional bias. , 2002, Journal of abnormal psychology.

[38]  N. Landrø,et al.  Neuropsychological function in nonpsychotic unipolar major depression. , 2001, Neuropsychiatry, neuropsychology, and behavioral neurology.

[39]  M. Thase,et al.  Cognitive disturbance in outpatient depressed younger adults: evidence of modest impairment , 2001, Biological Psychiatry.

[40]  S. Dutke,et al.  Test anxiety, working memory, and cognitive performance: Supportive effects of sequential demands , 2001 .

[41]  G. Goodwin,et al.  Cognitive deficits in depression: Possible implications for functional neuropathology , 2001, British Journal of Psychiatry.

[42]  Y. Sheline.  3D MRI studies of neuroanatomic changes in unipolar major depression: the role of stress and medical comorbidity , 2000, Biological Psychiatry.

[43]  P. Sullivan,et al.  Genetic epidemiology of major depression: review and meta-analysis. , 2000, The American journal of psychiatry.

[44]  E. Kaplan,et al.  Qualitative Block Design Analysis in Posttraumatic Stress Disorder , 2000, Assessment.

[45]  M. J. Emerson,et al.  The Unity and Diversity of Executive Functions and Their Contributions to Complex “Frontal Lobe” Tasks: A Latent Variable Analysis , 2000, Cognitive Psychology.

[46]  M. Posner,et al.  Cognitive and emotional influences in anterior cingulate cortex , 2000, Trends in Cognitive Sciences.

[47]  R. Bornstein,et al.  Relative memory deficits in recurrent versus first-episode major depression on a word-list learning task. , 1999, Neuropsychology.

[48]  P. Maruff,et al.  Neuropsychological function in young patients with unipolar major depression , 1997, Psychological Medicine.

[49]  H. Christensen,et al.  A quantitative review of cognitive deficits in depression and Alzheimer-type dementia , 1997, Journal of the International Neuropsychological Society.

[50]  H. Veiel,et al.  A preliminary profile of neuropsychological deficits associated with major depression. , 1997, Journal of clinical and experimental neuropsychology.

[51]  G. Logan,et al.  Impulsivity and Inhibitory Control , 1997 .

[52]  T. Robbins,et al.  Neuropsychological impairments in unipolar depression: the influence of perceived failure on subsequent performance , 1996, Psychological Medicine.

[53]  B. Sahakian,et al.  Cognitive performance in tests sensitive to frontal lobe dysfunction in the elderly depressed , 1996, Psychological Medicine.

[54]  G. Niederehe,et al.  Depression and memory impairment: a meta-analysis of the association, its pattern, and specificity. , 1995, Psychological bulletin.

[55]  J. Nurnberger,et al.  Diagnostic interview for genetic studies. Rationale, unique features, and training. NIMH Genetics Initiative. , 1994, Archives of general psychiatry.

[56]  A. Frances.  The Diagnostic Interview for Genetic Studies , 1994 .

[57]  E. Fox,et al.  Attentional bias in anxiety: A defective inhibition hypothesis , 1994 .

[58]  M. Eysenck,et al.  Anxiety and Performance: The Processing Efficiency Theory , 1992 .

[59]  R. Hales,et al.  J Neuropsychiatry Clin Neurosci , 1992 .

[60]  S. Nolen-Hoeksema,et al.  Responses to depression and their effects on the duration of depressive episodes. , 1991, Journal of abnormal psychology.

[61]  T. Robbins,et al.  Planning and spatial working memory following frontal lobe lesions in man , 1990, Neuropsychologia.

[62]  M H Broadbent,et al.  Performance correlates of self-reported cognitive failure and of obsessionality. , 1986, The British journal of clinical psychology.

[63]  D. Meyer,et al.  The point of no return in choice reaction time: controlled and ballistic stages of response preparation. , 1986, Journal of experimental psychology. Human perception and performance.

[64]  G. Logan,et al.  On the ability to inhibit simple and choice reaction time responses: a model and a method. , 1984, Journal of experimental psychology. Human perception and performance.

[65]  D. Rosielle,et al.  Psychiatry , 1905, NeuroImage.

[66]  Általános társadalom tudományok.  Semi-Structured Interview , 2022, The SAGE Encyclopedia of Research Design.

[67]  D. Wechsler.  Wechsler Adult Intelligence Scale , 2021, Encyclopedia of Evolutionary Psychological Science.

[68]  김의영,et al.  한국인 신경인지기능 평가를 위한 Cambridge Neuropsychological Test Automated Battery(CANTAB)의 신뢰성 평가 , 2012 .

[69]  René Hen,et al.  Genetics of affective and anxiety disorders. , 2006, Annual review of psychology.

[70]  Joyce L. Y. Chong.  ANXIETY AND WORKING MEMORY: AN INVESTIGATION AND RECONCEPTUALISATION OF THE PROCESSING EFFICIENCY THEORY , 2003 .

[71]  R. Hu.  Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) , 2003 .

[72]  Scientific.  International Standard Classification of Education, ISCED 1997 , 2003 .

[73]  S. Lautenbacher,et al.  Divided and selective attention in panic disorder. A comparative study of patients with panic disorder, major depression and healthy controls. , 2002, European archives of psychiatry and clinical neuroscience.

[74]  J. J. Ryan,et al.  Wechsler Adult Intelligence Scale-III , 2001 .

[75]  P. Neu,et al.  Comorbidity of mild cognitive disorder and depression – a neuropsychological analysis , 2000, European Archives of Psychiatry and Clinical Neuroscience.

[76]  M. Botvinick,et al.  The Contribution of the Anterior Cingulate Cortex to Executive Processes in Cognition , 1999, Reviews in the neurosciences.

[77]  A. Wenzel.  Cognitive Biases in Anxiety. , 1998 .

[78]  S. Kindermann,et al.  Depression and memory in the elderly: a meta-analysis. , 1997, Journal of clinical and experimental neuropsychology.

[79]  M. Denckla,et al.  A theory and model of executive function: A neuropsychological perspective. , 1996 .

[80]  Dan J Stein,et al.  Specificity of neuropsychological impairment in obsessive-compulsive disorder: a comparison with social phobic and normal control subjects. , 1996, The Journal of neuropsychiatry and clinical neurosciences.

[81]  M. Stein,et al.  Neurocognitive function in panic disorder and social phobia patients. , 1994, Anxiety.